Tdap Vaccine Distribution Program: Application Due January 20, 2017
The California Department of Public Health has generously made a limited amount of Tdap vaccine available. This vaccine may be administered to all clinically eligible patients ages 7 and up, regardless of the time frame since their last Td and regardless of insurance status. However, special effort should be made to vaccinate pregnant women, close contacts of infants less than 1 year of age, and close contacts of pregnant women and vaccines should be prioritized for uninsured and underinsured adults. For further information, review the CDC pediatric and adult vaccine schedules.
Open enrollment for the Tdap vaccine program is limited to once per year. Occasionally, special circumstances may allow for entry into the program outside of the normal open enrollment period. Participating providers must commit to accurate and timely documentation and reporting of vaccine usage, serving patients who are eligible for free or low-cost health care services, and fulfilling vaccine storage and handling requirements. Vaccines need to be stored at the right temperature (35 to 46°F) to protect your patients from disease. Adhering to vaccine storage and handling protocol is critical to the success and effectiveness of your vaccination efforts.
Continuation of the program depends on availability of vaccine. For more information about the program, please call (415) 554-2955 or download the application form and usage agreement.
Tdap Application Components: due Friday, January 20, 2017
- Application form
- Usage agreement
- Completed Checklist for Safe Vaccine Storage and Handling
- Key Staff Contacts Form
Returning applicants: have you had any staff changes since the last time you submitted an application to any SFDPH Immunization Program? If so, please have all new Vaccine Coordinators, new Back-Up Coordinators and any other new staff responsible for temperature monitoring take two online trainings: 1) "Storing Vaccines" and 2) "Monitoring Storage Unit Temperatures," both available at eziz.org/eziz-training.*
New applicants: Please have your Vaccine Coordinator, Back-Up Coordinators and any other staff responsible for temperature monitoring take two online trainings: 1) "Storing Vaccines" and 2) "Monitoring Storage Unit Temperatures," both available at eziz.org/eziz-training.* You may be asked to submit additional documents with your application, such as a temperature log for your vaccine storage unit. Contact firstname.lastname@example.org or email@example.com for more information.
Usage Report Due Dates:
- Usage report for the period from January 1 - June 30, 2017: Friday, July 7, 2017
- Usage report for the period from July 1 - December 31, 2017: Friday, January 5, 2018
Storage and Handling Requirements:
All vaccine recipients must adhere to the storage and handling standards outlined in the Checklist for Safe Vaccine Storage and Handling. Please note: effective fall 2016, all program participants must use a data logger as their primary thermometer.
A data logger is an electronic device that reads and records temperatures continuously and stores them in its internal memory. Temperatures can be viewed on a computer and saved as an electronic or paper file. Sites must also use a digital thermometer with a glycol probe as a back-up. If purchasing a data logger represents a financial burden to your practice, please let us know.
If you have any questions about storage and handling or any other part of the Tdap application, please do not hesitate to contact us -- we are here to help! Call (415) 554-2955 or write to firstname.lastname@example.org or email@example.com.
Tdap Vaccine Information Statement
Tdap Vaccine Authorization Record Form
Ad-Hoc Vaccine Request Form - organizations looking to request any vaccine (including Tdap) for a health fair or limited-time event, should complete this form and submit via fax to (415) 554-2579
* Please note: If your site does not participate in the VFC program, please do not report storage and handling incidents online at myvfcvaccines.org. If you need guidance when responding to a temperature excursion, please contact the SFDPH Immunization Program at (415) 554-2955.